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Improving care for critically ill patients

13 August 2013

Members of the trust learned more about the recent Xtreme Everest 2 trek at a ‘medicine for members’ event on 8 August.

Dr Daniel Martin, who is a senior lecturer and honorary consultant in anaesthesia and critical care medicine at University College London and the Royal Free, led Xtreme Everest 2, a medical investigation looking into hypoxia (low oxygen levels) in healthy volunteers going to high altitude, in a bid to bring benefits to patients with low levels of oxygen in intensive care.

Dr Martin said: “Everyone responds to low levels of oxygen in different ways, which is a big problem for us in intensive care. However, if you can survive low levels of oxygen at altitude at the top of a mountain, perhaps you can still function normally with low oxygen levels as a patient on intensive care”

The first Xtreme Everest trek in 2007 was a broad investigation of the effects of altitude, and based on that work the scientists returned to Everest this year with more specific aims. Dr Martin explained the researchers were keen to understand more about how mitochondria and the microcirculation respond to hypoxia.

Dr Martin said: “There are lots mitochondria in your cells, they take oxygen use it to generate energy. We couldn’t survive without them. But the way in which each person’s mitochondria reacts to the low levels of oxygen might be the key to how oxygen is used.”

After three months in Nepal, Dr Daniel Martin is back at work on the intensive care unit at the Royal Free having led the medical research trek. More than 200 volunteers, including children, twins and Sherpas took part in the research. Thousands of tests were carried out in makeshift laboratories at the 5,300m high Everest base camp at Namche Bazaar, a small settlement 3,500 metres above sea level on the way to base camp and in Kathmandu at 1300m.

The experiments included performance testing on exercise bikes; the collection of blood, saliva, hair, urine, nasal swabs and muscle samples; lung function and muscle and skin oxygenation measurement; and various ultrasound scans and heart ECG measurements.

Dr Martin said: “We have safely brought back to the UK around 15,000 samples from our time in Nepal. We have a huge data analysis plan ahead but hope to start publishing results from this trek in the next 12 months.

“Conducting these sorts of scientific tests of such complexity was a real challenge in the conditions we faced. Collecting this data is the beginning of a long journey and we hope it will ultimately lead to improved care of critically ill patients.”

ENDS

Notes to editors

Xtreme Everest is a dedicated team of intensive care doctors, nurses and scientists. They conduct experiments on themselves and other volunteers at high altitude in order to develop novel therapies to improve the survival rates of their patients. Because it is very difficult to study patients in intensive care units, not least because they are so ill, the team volunteer themselves as subjects.

The Royal Free attracts patients from across the country and beyond to its specialist services in liver, kidney and bone marrow transplantation, haemophilia, surgery for hepatopancreatobiliary (HPB) conditions, clinical neurosciences, renal, HIV, infectious diseases, plastic surgery, immunology, vascular surgery, cardiology, amyloidosis and scleroderma and is a member of the academic health science partnership UCLPartners.